| NPI | 1457735615 |
|---|---|
| Former Legal Business Name | COASTLINE FOOT AND ANKLE CENTER |
| Entity Type | Organization |
| Authorized Contact | LINZIE GOMEZ Manager 503-370-8784 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OR DP154513) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2020-03-10 |